CAMP KNOX 2021

REGISTRATION

541 Long Beach Rd, St James, NY 11780 camp_info@knoxschool.org 631-686-1640

Camper Information

First Name

Last Name

Gender

Birth Date +

'20-'21 Grade

Tee Shirt Size *

One Buddy Request

Returning Camper? *

Household Information

Parent/Guardian #1 First Name *

Last Name *

Address *

City *

State *

Zip *

Phone *

Cell Phone *

Email Address *

Parent/Guardian #2 First Name

Last Name

Address if different

City

State

Zip

Phone

Cell Phone

Email Address

Emergency Contacts

Please provide contact information for 2 trusted people who have your permission to pick up your child in case of emergency in the event that we can not reach the parents listed above. Parents will always be contacted first.

Contact #1 Name: *

Relationship to camper: *

Home Phone: *

Cell Phone: *

Contact #2 Name: *

Relationship to camper: *

Home Phone: *

Rates

Buy more and Save! Early bird camp rates can be seen on our website campknox@knoxschool.com. These rates are good until 4-30-21 and must be paid in full by May 31, 2021.

Name on Card Or Checking Account *

Bank Account

Credit Card

Cash

Credit Card Type ( we do not accept American Express)

Credit Card Number

Expiration Date (mm/yy)

CVA Code

Bank Account Routing #

Bank Account #

CAMP KNOX 2021

Please let us know how many days you are registering for. A deposit of $500 is required to hold your child's spot once the registration is submitted. You will receive an invoice stating the amount for the days you have requested and the amount due before camp starts. Schedules are due no later than May 15, 2021.

Equestrian Camps

Please choose

Session 1 $2250

Session 2 $2250

Notes:

Terms & Conditions

Please sign to acknowledge you have read and agree to the terms and conditions *

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